Related Experiment Video
Updated: Aug 31, 2025
Following in Real Time the Impact of Pneumococcal Virulence Factors in an Acute Mouse Pneumonia Model Using Bioluminescent Bacteria
Published on: February 23, 2014
Epidemiology of pediatric parapneumonic pleural effusion during 13-valent pneumococcal conjugate vaccine
Luis Moral1, Teresa Toral1, Nuria Marco2
1Unidad de Neumología y Alergología Pediátrica, Hospital General Universitario de Alicante, Instituto de Investigación Sanitaria y Biomédica de Alicante (ISABIAL), Alicante, Spain.
Insights
Despite the 13-valent pneumococcal conjugate vaccine, pediatric parapneumonic pleural effusion incidence remained stable. Researchers noted significant regional disparities in effusion rates across health departments.
Area of Science:
- Pediatric infectious diseases
- Respiratory medicine
- Epidemiology
Background:
- Parapneumonic pleural effusion (PPE) incidence, including empyema, has fluctuated.
- These changes have been linked to conjugate pneumococcal vaccine implementation.
Purpose of the Study:
- To analyze temporal trends in pediatric PPE incidence.
- To investigate the impact of the 13-valent pneumococcal conjugate vaccine (PCV13) on PPE rates.
- To identify geographical variations in PPE incidence.
Main Methods:
- Retrospective review of 366 pediatric PPE cases (2010-2018) across 10 hospitals in Alicante Province, Spain.
- Data stratified by effusion size: PE- (<10 mm) and PE+ (≥10 mm).
- Analysis of bacterial agents, serotypes, and incidence rates per 100,000 children.
Main Results:
- Mean annual incidence of 14.3 PPE cases per 100,000 children under 15.
- Streptococcus pneumoniae was the most common pathogen (24 cases), with serotype 19A predominant.
- No significant temporal changes in incidence observed post-PCV13 introduction; notable inter-departmental incidence disparities found.
Conclusions:
- No temporal variations in pediatric parapneumonic effusion incidence were detected following PCV13 implementation.
- Significant and unexplained differences in incidence exist between adjacent health departments, warranting further investigation.
Introduction:
The reported incidence of parapneumonic pleural effusion, including empyema, has shown fluctuations in the last decades. It has been related to the implementation of different types of conjugate pneumococcal vaccines.
Methods:
We have retrospectively reviewed data from all 10 public hospitals in Alicante Province (Spain) covering a population of 279,000 children under 15 years of age, between 2010 and 2018. Effusions less than 10 mm (PE-) and those of 10 mm or more (PE+) were separated.
Results:
A total of 366 episodes of parapneumonic pleural effusion have been analyzed, 178 PE- (48.6%) and 188 PE+ (51.4%), with a median age of 4 years (interquartile range: 2-7 years) and marked seasonality with the maximum in winter and the minimum in summer. A culture proven bacterial agent was identified in 34 patients (9.3%), mainly Streptococcus pneumoniae (24 patients) followed by Streptococcus pyogenes (7 patients). The most frequent S. pneumoniae serotype was 19A (6 patients) and 3 vaccine failures were observed. The mean annual incidence rate was 14.3 cases per 100,000 children under 15 years of age (7.0 for PE- and 7.3 for PE+). No significant changes were observed in incidence over time, but noticeable differences in incidence were observed in different health departments.
Conclusions:
We have not found temporal variations in incidence of parapneumonic effusion despite the implementation of the 13-valent pneumococcal conjugate vaccine. The unexplained disparity in incidence between close departments is noteworthy.
Related Concept Videos
01:30Pneumonia III: Complications and Assessment
01:28Pleural Effusion II: Symptoms and Management
A pleural effusion is the abnormal collection of fluid between the parietal and visceral pleura layers of tissue that form the lining of the lungs and chest cavity. It can occur independently or due to surrounding parenchymal diseases, such as infection, malignancy, or inflammatory conditions.
Clinical Manifestations:
01:30Pneumonia V: Nursing management and Prevention
The nurse must practice strict medical asepsis and adhere to infection control guidelines to minimize healthcare-associated infections.
Enhance airway patency
Position the patient correctly to facilitate drainage of the affected lung segments. Manual or mechanical percussion and vibration can also be employed....
01:30Pneumonia I: Introduction
Risk Factors
Various factors influence the likelihood of developing pneumonia. Age plays a crucial role, with infants, children under two, and individuals over 65 at increased risk due to their...
01:25Pleural Effusion I: Introduction
There are two main types of pleural effusion: transudative and exudative. They are differentiated using Light's...
01:29Pneumonia II: Pathophysiology